肺腺癌中的TTF-1、NAPSINA 病理诊断的临床应用效果
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潘钰，孙田野，李妍，周萍
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1. 泰兴市人民医院 病理科，江苏泰兴，225400；2. 泰兴市人民医院 急诊科，江苏泰兴，225400；3. 泰兴市人民医院 神经内科，江苏泰兴，225400
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摘要：目的 分析肺腺癌诊断中应用甲状腺转录因子－ 1(TTF － 1) 、天冬氨酸蛋白酶 A(NAPSINA)的临床效果。方法 选择本院2024年1月—12月期间，经手术或者穿刺活检已确诊的120例肺腺癌患者，作为本次实验对象，以病理学组织诊断为金标准，均进行TTF-1（克隆号380）与NAPSINA（克隆号320）的免疫组化检测，评估临床诊断的效果。结果 120例肺腺癌患者中，92例患者的TTF-1表达为阳性，阳性率为76.67%，88 例患者的 NAPSIN A 呈阳性，阳性率73.33%，联合检测阳性例数为110 例，阳性率为91.67%。以病理学为金标准，TTF-1 灵敏度为76.67%，特异度90.00%，准确率为80.00%，阳性预测值94.85%，阴性预测值62.50%；NAPSIN A 对肺腺癌的灵敏度为73.33%，特异性、准确率分别为87.50% 和77.50%，阳性与阴性预测值分别为93.62% 和58.33%；联合组的灵敏度、特异性、准确率分别为91.67%、85.00% 和90.00%，阳性和阴性预测值分别为95.65% 和79.17%，并且与单纯TTF-1 或 NAPSIN A 的检测结果比较，联合组的诊断效果更高，具有统计学意义，（P<0.05）。临床特征分析，不同分化程度与有淋巴结转移的患者中，TTF-1 与NAPSIN A 的阳性表达率，差异有统计学意义（P<0.05）。结论 TTF-1和 NAPSIN A的结合能明显提高肺腺癌细胞的组织学诊断敏感性、准确性、阳性与阴性预测值，对肺腺癌细胞的诊断以及患者的预后，均有重要的指导意义。
关健词：肺腺癌；TTF-1；NAPSINA；病理诊断
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Clinical Application of TTF-1 and NAPSINA in Pathological Diagnosis of Lung Adenocarcinoma
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Yu Pan,Tianye Sun,Yan Li,Ping Zhou
1.Department of Pathology, Taixing People’s Hospital, Taixing,Jiangsu 225400,China;2.Emergency Department,Taixing People’s Hospital, Taixing,Jiangsu 225400,China;3.Neurology Department,Taixing People’s Hospital, Taixing,Jiangsu 225400,China
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Abstract：Objective To evaluate the clinical efficacy of thyroid transcription factor-1 (TTF-1) and aspartate aminotransferaseproteinase A (NAPSINA) in diagnosing lung adenocarcinoma. Methods A total of 120 patients diagnosed with lungadenocarcinoma through surgical resection or biopsy between January and December 2024 were selected as subjects. Immunohistochemicaldetection of TTF-1 (clone 380) and NAPSINA (clone 320) was performed using histopathological diagnosis asthe gold standard to assess diagnostic effectiveness. Results Among the 120 patients, 92 showed positive TTF-1 expression(76.67%), while 88 had positive NAPSINA expression (73.33%). Combined detection identified 110 positive cases (91.67%).Using pathology as the gold standard, TTF-1 demonstrated a sensitivity of 76.67%, specificity of 90.00%, accuracy of 80.00%,positive predictive value (PPV) of 94.85%, and negative predictive value (NPV) of 62.50%. The NAPSIN A showed a sensitivityof 73.33% for lung adenocarcinoma, with specificity and accuracy at 87.50% and 77.50% respectively, corresponding to PPVand NPV of 93.62% and 58.33%. In the combined group, these parameters reached 91.67%,85.00%, and 90.00%, with PPV andNPV of 95.65% and 79.17% respectively. Compared to standalone TTF-1 or NAPSIN A testing, the combined approach showedstatistically significant higher diagnostic efficacy (P<0.05). Clinical characteristic analysis revealed statistically significant differencesin TTF-1 and NAPSIN A positive expression rates between patients with different differentiation grades and lymph nodemetastasis (P<0.05). Conclusion The combination of TTF-1 and NAPSIN A significantly enhances the sensitivity, accuracy,and PPV/NPV of histological diagnosis for lung adenocarcinoma cells, providing important guidance for both clinical diagnosisand patient prognosis.
Keywords : Lung adenocarcinoma; TTF-1; NAPSIN A; Pathological diagnosis
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